- Extraction of primary (baby) teeth: this procedure may be recommended if there are signs of teeth crowding and the permanent teeth are malpositioned or erupting in the wrong direction due to lack of adequate room.
- Extraction of permanent premolars: permanent premolars may be recommended for extraction in those patients with severe crowding and impaction of the canine or molars. Most commonly, all four first premolars are extracted although this may vary depending on the bite and degree of crowding. Your orthodontist should make the recommendations.
- Canine exposure: canine teeth often erupt at age 12 to 13. Delayed eruption is often caused by impaction of the canines and poor alignment. Your orthodontist may recommend you to the oral surgeon to expose the canine and attach a bracket to help them align the canine and erupt it into the mouth.
- Corrective jaw surgery: patients with facial skeletal discrepancies and poor bite relationships may be recommended for corrective jaw surgery. The orthodontist will work in collaboration with the oral surgeon to align teeth and the jaws for an improved bite and facial harmony.
- Temporary anchorage devices: occasionally, an orthodontist may request the oral surgeon to place special anchorage screws to help them align the teeth better. Such devices are very easy to place and only take a few minutes and provide orthodontist better control and improved results of the bite.
- Dental implants: if a tooth is not replaced in timely fashion following tooth extraction, the adjacent of opposing teeth may shift. The orthodontist may recommend to upright teeth that have shifted in order to create space for dental implant and a new tooth replacement.
- Wisdom teeth removal: although the relationship between wisdom teeth and crowding of adjacent teeth is not entirely understood, your orthodontist may recommend to extract the wisdom teeth to prevent relapse or shifting of adjacent teeth following completion of orthodontic treatment. Occasionally, they may request removal of the wisdom teeth during the orthodontic treatment to allow crowded teeth to erupt or create space to align the other teeth.
Who will make recommendations for surgery?
The orthodontist will often make the recommendations for necessary surgery to help them achieve a better bite. On occasion, a pediatric dentist or a general dentist performing orthodontic treatments may request such procedures.
- Extraction of primary (baby) teeth: most often between ages of 8 and 13
- Extraction of adult premolars: between ages of 11 and 15 but may also be recommended in adults
- Canine exposure: Between ages of 12 and 14
- Corrective jaw surgery: After age 16 in females and 19 to 21 in males (when growth has been completed)
- Temporary anchorage devices: May be requested at any age, but most often in adults
- Dental implants: After age 16 in females and 19 to 21 in males (when growth has been completed)
- Wisdom teeth removal: Age 16 to 20 although occasionally may be earlier.